The following excerpt is from a film review by Elizabeth Kerr:

A sensual May-December romance between a popular romance writer and her student-turned-assistant takes a tragic turn when her early onset Alzheimer's asserts itself in Butterfly Sleep...

"Onset" is a noun but it seems it is used as an adjective here. Or are you allowed to have two nouns (onset and Alzheimer's) in a row?

How could you write this sentence differently, using "onset" in a simpler way, so I didn't have to debate if using two nouns were a problem?

Thank you very much.

  • "Early onset Alzheimer's" is a particular manifestation of Alzheimer's disease. Commented Dec 22, 2017 at 19:48
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    Lots of nouns are used adjectivally. "I've just been attending to my car radio". In this case of a compound pre-position adjective, many people (including myself) would use a hyphen - "...when her early-onset Alzheimer's asserts itself..."
    – WS2
    Commented Dec 22, 2017 at 20:38
  • 'Onset' is not, to my knowledge, used attributively, but 'early[-]onset' is a well-known compound premodifier in this context. Compare fast breeder in fast breeder reactor. Commented Dec 23, 2017 at 9:34
  • A Google search for "early onset Alzheimer's" is required. A refined search for "onset Alzheimer's" -"early-onset Alzheimer's" shows classmates such as "younger-onset Alzheimer's" and "late-onset Alzheimer's". But probably no non-compound examples. A search for "early-onset" + "meaning" is thus indicated. / Just looking up 'onset' at Longmans leads you to the answer. / Research is required to be shown where it may reasonably be expected. / The attributive use of nouns has been addressed far too often on ELU. It is an extremely common, but not a totally productive feature of English. Commented Dec 23, 2017 at 12:06
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    I voted to reopen this question because Merriam-Webster's Eleventh Collegiate Dictionary (2003) and The American Heritage Dictionary of the English Language, fifth edition (2010)—the most recent editions of these two standard U.S. references—have no entry for onset as an adjective and no entry for early[-]onset as a set phrase. When reasonable basic research fails to yield an answer to a poster's question, I think it is disingenuous to tell the poster, in effect, "if you had done the appropriate basic research, you would have found the answer you are looking for."
    – Sven Yargs
    Commented Dec 23, 2017 at 19:59

1 Answer 1


Onset is not being used as an adjective here. The adjective is “early onset”, which would perhaps have been better hyphenated as “early-onset” for clarity. As such the combination has a specific clinical temporal meaning. Thus, the Oxford Dictionaries online gives the definition:



(Of a medical condition) occurring relatively early in life, especially as compared to a different form of the same condition; of, relating to, or affected by such a condition.


1950s; earliest use found in Proceedings of the Royal Society of Medicine.

  • Please (a) don't answer questions on ELU where the OP should have done the basic research themself / (b) don't confuse ODO (to which you link) with OED (online or otherwise). Commented Dec 23, 2017 at 8:44
  • @EdwinAshworth — (b) Changed. (a) It is only your subjective opinion that this is the case. What is clear is that I have followed SE policy of answering a question as an answer, not as a comment. This is in contrast to the two "comments" to the question which are clearly answers and against explicit SE policy. If you are going to upbraid members for contravening SE policy, you might direct your fire to the right quarter.
    – David
    Commented Dec 23, 2017 at 9:06
  • I was merely extending the courtesy of explaining my downvote. Most people complain when they receive unexplained downvotes. // Hopefully, other users will add to the 3 closevotes so far attaching to this question. There are 2 000 000 hits on Google for a search for early + onset. ELU is a site aimed at linguists, not beginners, and some users strive to maintain standards. Performing dictionary and other simple and obvious searches for people hardly adds to the site's credibility. Commented Dec 23, 2017 at 9:29
  • To quote Mari-Lou A in Meta: 'Nearly everybody does it. Write answers. In comments.' In answer to anongoodnurse's 'However, I feel a bit silly answering some questions in Answers.' And Reg Dwight has said: '[W]e write stuff in comments that is too obvious to qualify for an answer.' Commented Dec 23, 2017 at 9:52
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    Since I was the commenter who provided an "answer", perhaps I should justify this rather than rely on @Edwin Ashworh to take up the cudgels. If a question addresses a very simple, beginners understanding of English I do one of two things. Either I suggest they go to ELL. Or if it is borderline I give an explanation in comments, as I did here. For an experienced native speaker to provide a formal answer, would seem to be ungentlemanly, a bit like potting your opponents ball in billiards.
    – WS2
    Commented Dec 23, 2017 at 11:40

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